Dear Nurse Beth,
I am a new grad about 9 months into my first job...in the ICU. I have had 2 performance evals and the first was "you're doing a good job, you're still new and need to improve on this..." but the most recent one broke my spirit. I racked up overtime (more than other new grads on the floor)...not too ridiculous, I think...like 2-3 hrs per pay period (which is like an avg of 30 min per shift) mainly to scramble on charting.
Some items mentioned I can completely understand needing to work on- time management, better communication with doctors/charge RN, more proactive with asking for orders/knowing what med to request...but it felt so soul-crushing to hear them say things like they were concerned for a patient's safety under my watch. Also, some negative items on my eval were when I ask experienced RNs for advice on an issue and followed their advice!
I was so heartbroken, disappointed in myself, and also annoyed with certain things that I felt were not my fault. (A nurse complained about my colostomy bag leaking...I watched her replace my bag and she put the new bag on the exact same way I did!)
The hospital is very far from my house...and I recently got an interview for a hospital (also ICU) 5 minutes away from home. (I know I have no offer YET...but I'm just thinking it over...) I'm torn. I don't want to be a sore loser/quitter in leaving my current hospital after a bad eval especially since this hospital is much bigger, probably has more high acuity pts/ better learning experience, (better benefits), and newer technology/equipment, and the team is very knowledgeable and nice (some of them). 5 min drive vs 1.5-2hr drive is tempting though.
Any advice? I've even considered that I'm not cut out for ICU or should go lower acuity to get more experience then switch later if I want?
Dear New Grad,
I'm sorry for your experience so far. This has got to be very tough.
If you are offered and take the new job in ICU, you will soon know if you are cut out for ICU or not. Meaning if after a time you receive a poor performance evaluation, you will know it's you, not the organization. On the other hand, you may settle in and hit your stride.
Staying regularly 20-30 minutes after shift is taken seriously by management because of the bottom line. It may help to transfer to a lower-acuity unit, although consider that time management problems can be exacerbated with 5-6 MedSurg patients.
It's usually recommended to to stick with your position at least for one year, but there are exceptions. if your job is at risk, it's better to quit than to be fired. If a workplace is toxic or unsafe, same goes.
So there are a lot of options- and the best choice will be one that is a solution to your problem. What do I recommend? Consider transferring to MedSurg. Why do I say that?
1. You will not be terminated from the ICU
2. It will give you extra time to build your nursing practice and develop
3. It is a benefit to remain with the same organization for a year or two- you can change jobs closer to home later
4. From personal experience, I have seen nurses thrive once they transfer to a different unit.
If you decide to stick it out in your current setting because of some of the advantages you've mentioned, you need specific and measurable goals from your manager in order to succeed.
When You Receive a Warning at Work
is a must-read for you.
Best wishes on your decision,
Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!